Corruption In US Health Care by https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb By: Michael Santiago en-us 2020-11-12 19:38:56 UTC 2023-02-08 14:48:40 UTC hello@padlet.com https://padlet.net/icons/png/1f1fa-1f1f8.png 1. What is corruption? michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/922982873 Corruption - Intentional abuse of power for private gain, that can be committed by anyone within any process or level of an organization. ]]> 2020-11-14 17:21:52 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/922982873 3. How much money is lost due to fraud? michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923006055 It is estimated that about 10% of the total health care expenditure or 105-350 billion is lost every year in the US due to fraud. (Intelligence & Intelligence, 2019) ]]> 2020-11-14 17:40:26 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923006055 References michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923018260 Intelligence, E., & Intelligence, E. (2019, June 07). A Ripple Effect of Healthcare Fraud in the USA. Retrieved November 14, 2020, from https://www.eos-intelligence.com/perspectives/life-sciences/a-ripple-effect-of-healthcare-fraud-in-the-usa/

Wierzynska, A., Steingrüber, S., Oroxom, R., & Bauhoff, S. (2020). Recalibrating the anti-corruption, transparency, and accountability formula to advance public health. Global Health Action, 13 doi:http://dx.doi.org.ezproxy.fau.edu/10.1080/16549716.2019.1701327]]> 2020-11-14 17:50:22 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923018260 2. How corruption affects patient care? michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923023285
  • Financing of health care becomes an even greater problem, limiting availability of government programs. 
  • Patients lose trust in the healthcare system due to lack of integrity. 
  • Resources such as equipment, medications, supplies and trained personnel become scarce. 
  • Patients are diagnosed with illnesses they may not have, prescribed medications they do not need, or have unnecessary procedures done all to financially benefit the person or persons committing the act of corruption.
    • ]]>     2020-11-14 17:54:09 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923023285     4. Organizations battling corruption. michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923054670
  • The WHO (World Health Organization), UNDP (United Nations Development Programme), and the Global Fund created the Alliance for Anti-Corruption Transparency, and Accountability in Health initiative. 
  • This Alliance was created to identify challenges and find solutions to prevent corruption. 
    • ]]>     2020-11-14 18:19:39 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923054670     7. FRA Method (Fraud Risk Assessment) michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923115979
  • Designs context-specific corruption prevention controls.
  • Recommended by internal control, audit and fraud examiner associations. 
  • Founded on risk-based approach. 
    • ]]>     2020-11-14 18:45:11 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/923115979     8. Risk vs Compliance michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924705814
  • There are two ways to approach corruption, the risk-based approach and the compliance approach. 
  • The compliance approach puts more trust into the system. It believes that if all of the regulations seem to be followed and all of the documents and signatures are present then no fraud must have occured. 
  • The risk-based approach does the opposite. It understands that those documents as described above could very well be forged so it looks at which issues cause the greatest risks. 

    • ]]>     2020-11-15 16:20:51 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924705814     6. Fraud Triangle Theory michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924738891 Used to explain why an individual committed fraud. ]]> 2020-11-15 16:40:05 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924738891 9. What to consider when designing your own preventative measures. michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924763507
  • The steps of the process.
  • Who performs each step of the process.
  • How payments are received. 
  • Checks and balances. 
  • Documentation requirements.
  • Verifications, supervision and oversight policies. 
  • Incentives. 
    • ]]>     2020-11-15 16:54:36 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924763507     10. Notable Healthcare Fraud Scheme in the USA michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924775325 2020-11-15 17:01:46 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924775325 5. Fraud and Covid-19 michaelsanti2018 https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924787626 With Covid-19 creating havoc across the world many people have used this opportunity to capitalize on relaxed policies by committing fraud in the Healthcare system, from phony test kits to logistical fraud. ]]> 2020-11-15 17:09:40 UTC https://padlet.com/michaelsanti2018/87uwkrgoeqmmwgjb/wish/924787626